THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY.
Effective September 23, 2013
The privacy of your medical information is important information to the Orthopaedic Center of Southern Illinois (“Center”).We are committed to protecting medical information about you. The following categories describe different ways that we may use and disclose your medical information. The examples in this notice are merely examples and do not include every possible use or disclosure.
•For Treatment. We may use medical information about you to provide you with medical treatment or services. For example: Information obtained by a nurse, physician or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you.
•For Payment. We may use your medical information to obtain payment for our services. Your health records as well as your billing records may be disclosed to another party, such as an insurance carrier, etc., if they are responsible for the payment of your services.
•For Health Care Operations. We may use and disclose medical information about you for Center operations. These uses and disclosures include our overall business operations and health care service. For example, we may use your medical information to review our treatment and services and to evaluate the performance of our staff in caring for you.
•Communication. Your name, address, and phone number may be used to contact you regarding appointments, or information regarding your care, or the status of your account.
•Research. Under certain circumstances, we may use and disclose information about you for research purposes. We will obtain specific permission from you if we use pictures or any other identifiable information about you.
•Individual Involved in Your Care of Payment for Your Care. We may release medical information about you to a caregiver who may be a friend or family member, which is relevant to their involvement in your care, including payment for your care.
•As Required By Law. We will disclose medical information about you when required to do so by federal, state, or local law.
•Military. If you are a member of the armed forces, we may release medical information about you as required by military command authorities.
•Public Health Risks (Health and Safety to you and/or others). As required by law, we may disclose medical information about you for public health activities.
- To prevent or control disease, injury or disability;
- To report child abuse or neglect;
- To report reactions to medications or problems with products;
- To notify people of recalls of products they may be using;
- To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and
- To notify the appropriate government authority if we believe a patient has been a victim of abuse, neglect or domestic violence. We will only make this disclosure when required or authorized by law.
•Lawsuits and Disputes. If you are involved in a lawsuit or dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery requests or other lawful process by someone else involved in the dispute.
•Health Oversight Activities. We may disclose information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, and licensure. These activities are necessary for the government to monitor health care system, government programs, and compliance with civil rights.
Law Enforcement. We may release medical information for law enforcement purposes as required or permitted by applicable law;
- In response to a court order, subpoena, warrant, summons or similar process;
- To identify or locate a suspect, fugitive, material witness or missing person;
- About a death we believe may be the result of criminal conduct;
- About criminal conduct as the Clinic; and
- In emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
•Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner, medical examiner or funeral director to identify a deceased person or determine the cause of death.
•National Security and Intelligence Activities. We may release medical information about you to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.
•Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or to conduct special investigations.
•Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary for the institution to provide you with health care, to protect your health or the health and safety of others, or for the safety and security of the correctional institution.
•Business Associates. There are some services provided by our organization through contacts with business associates. Examples include collection proceedings by our attorney. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked them to do. So that your health information is protected; however, we require the business associate to appropriately safeguard your information.
Your Rights Regarding Medical Information About You
•Right to Inspect and Copy. You have the right to inspect and copy medical information that may be used to make decisions about your care. You must submit this request in writing and allow two (2) business days to fulfill this request. We will charge a fee for the cost of copying as allowed by applicable law. We may deny your request to inspect and copy your medical information in certain very limited circumstances. If you are denied access to your medical information, you may request a review of that denial. Any such review will be performed by a licensed health care professional chosen by the Center, other than the person who initially denied your request. We will comply with the outcome of the review.
•Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the Center. To request an amendment, your request must be made in writing and must state the reason. We will notify you as to whether we agree or disagree with the requested amendment. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that was not created by us (unless the person or entity that created the information is no longer available to make the amendment), is not part of the information kept by or for the Center, is not part of the information which you would be permitted to inspect and copy, or is accurate and complete.
•Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. To request restrictions, you must make your request in writing stating what information you want to limit, to whom you want the limits to apply and whether you want to limit use, disclosure, or both. We have the right to deny any such requests, except for certain disclosures to health plans when you have paid in full for a health care item or service.
•Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or in a certain location. For example, you can ask that we only contact you at specific places or means, such as at work or by mail. You must make this request in writing and specify how or where you wish to be contacted.
•Right to a Paper Copy of This Notice. In the event you receive this notice electronically, you have the right to a paper copy of this privacy notice. You may ask us to give you a copy of this privacy notice at any time by requesting a copy from any member of the Center.
- Maintain the privacy of your medical information;
- Provide you with this notice describing our legal duties and privacy practices with respect to information we collect and maintain about you; and Abide by the terms of this notice.
We reserve the right to change this notice and our practices and to make the new provisions effective immediately for all protected health information we maintain. Any uses or disclosures other than those outlined in this notice will be made only with your written authorization, which you may revoke at any time in writing, except to the extent that we have taken action in reliance upon it, such uses or disclosures could include the release of psychotherapy notes, use of medical information for marketing information or actions which could entail the sale of medical information.
Right to Receive a Breach Notice. You have the right to receive notice of an improper access, use or disclosure of your medical information which constitutes a breach under federal or state law and such a notice is required.
For More Information or to Report a Problem
If you have questions and would like additional information, you may contact the Privacy Officer at 618-242-3778 ext. 213.
If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer at the Orthopaedic Center of Southern Illinois. You have the right to file a written complaint with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.